Key Takeaways

• Many Medicare enrollees in 2025 are still making the same critical errors that lead to higher out-of-pocket costs or reduced coverage.

• A clear understanding of plan networks, drug formularies, and enrollment periods is essential to avoid costly mistakes.

Why Your Open Enrollment Choices Matter More Than Ever

Medicare Open Enrollment, which runs annually from October 15 to December 7, gives you the opportunity to review and change your Medicare coverage. Whether you’re in Original Medicare or a Medicare Advantage plan, this is your one chance each year to make adjustments based on changing needs, costs, or plan offerings.

Yet each year, a significant portion of enrollees either don’t take advantage of this period or make decisions based on outdated or incomplete information. In 2025, with plan changes becoming more frequent and complex, these missteps can have lasting consequences.

1. Not Reviewing Your Current Coverage

Many beneficiaries assume that sticking with their current plan is the safest option. While that may feel comfortable, it can be costly. Plans often change their costs, coverage, provider networks, and drug formularies each year.

What can change annually:

• Monthly premiums and deductibles

• Copayments for doctors or prescriptions

• In-network doctors and hospital affiliations

• Drug coverage and tiers in Part D plans

Failing to review these changes can result in higher expenses or unexpected denials for services or medications you previously received.

2. Ignoring the Annual Notice of Change (ANOC)

Every fall, your plan sends you an ANOC detailing any changes for the coming year. Too often, this document goes unread.

In 2025, ANOC letters include details about:

• Increases in premiums, deductibles, or copayments

• Medications that will no longer be covered

• Changes to supplemental benefits

Ignoring this notice means you may walk into the new year with incorrect expectations about your benefits.

3. Not Comparing Plans

Even if your current plan still fits your needs, it may no longer be the best available option. Many people only compare a couple of plans—or none at all.

In 2025, plan offerings continue to diversify. New features and supplemental benefits might be available, or your plan’s cost structure may now be less competitive than others.

Comparison points to review:

• Total annual costs (not just premiums)

• Access to preferred doctors and hospitals

• Drug coverage for your specific medications

• Out-of-pocket maximums

4. Misunderstanding Drug Coverage Changes

Medicare Part D plans often restructure their formularies. A drug that was covered affordably in 2024 may have moved to a higher tier in 2025—or may no longer be covered at all.

To avoid surprises:

• Use the Medicare Plan Finder tool or speak with a licensed agent listed on this website

• Check each plan’s formulary for your current prescriptions

• Review tier placements and any step therapy or prior authorization requirements

5. Assuming Medicare Advantage Always Includes All You Need

Medicare Advantage plans often promote added benefits like dental, vision, and hearing. However, these extras can distract from limited provider networks or increased cost-sharing.

In 2025, supplemental benefits are still widely advertised, but they vary significantly in quality and usability. You may find that those appealing extras come with tradeoffs such as:

• Higher out-of-pocket maximums

• Restricted access to specialists

• Prior authorization delays

Make sure the plan offers reliable core medical coverage—not just bells and whistles.

6. Overlooking Provider Network Changes

Medicare Advantage plans operate with specific provider networks. If your doctors leave the network—or if the plan contracts with fewer providers—you may be forced to switch doctors or pay more.

Each year, insurers renegotiate contracts, and many enrollees discover that their doctor is no longer considered in-network only after the new year starts.

Action to take:

• Confirm whether your providers will still be in-network for the upcoming year

• Use plan directories but also verify with the provider’s office directly

7. Waiting Too Long to Make a Decision

Open Enrollment lasts about eight weeks, but many people procrastinate until the final days. This rush can lead to snap decisions or technical errors in submissions.

Submitting your changes early gives you time to:

• Compare multiple options thoroughly

• Resolve errors or incomplete applications

• Ask questions and get clarifications

8. Assuming You Can Change Plans Anytime

One of the most common misconceptions is that you can change Medicare plans anytime you want. That’s rarely true. Unless you qualify for a Special Enrollment Period (such as moving or losing employer coverage), you must wait until the next Open Enrollment.

Outside the window of October 15–December 7, your plan choice typically locks in for the entire year.

9. Not Factoring in Travel or Relocation

If you plan to travel frequently or move—even seasonally—you must ensure your Medicare coverage can move with you. Original Medicare works nationwide, but Medicare Advantage plans usually have regional provider networks.

If you split time between states or travel for extended periods:

• Make sure the plan includes nationwide coverage or out-of-area emergency care

• Consider the portability of your drug and supplemental benefits

10. Underestimating the Impact of the New Drug Cost Cap

As of 2025, Medicare now includes a $2,000 annual cap on out-of-pocket prescription drug costs under Part D. This is a significant benefit, but some enrollees mistakenly believe it applies to all plans equally or that it eliminates all drug expenses.

The cap only applies after deductible and coinsurance thresholds are met. Additionally:

• Not all plans structure their coverage the same way

• Drugs not covered by the plan’s formulary still cost you fully

Understanding how the cap fits into the broader Part D structure helps you avoid overestimating savings.

11. Relying on Outdated Advice

Medicare rules and plans change every year. Advice from friends, family, or even professionals based on 2022 or 2023 standards may no longer be accurate in 2025.

Common examples of outdated advice:

• Recommending a plan based on last year’s formulary

• Ignoring new cost structures or benefit changes

• Assuming past rules about plan switching still apply

Always verify any information against current year data.

12. Not Asking for Help

Many enrollees feel overwhelmed by the options and terminology, but don’t reach out for help. Trying to navigate Medicare alone can lead to avoidable mistakes.

Licensed agents listed on this website can:

• Help you compare plan options

• Explain how changes impact you directly

• Guide you through enrollment steps correctly

Being More Prepared in the Next Open Enrollment

The good news is that mistakes from past Open Enrollment periods can often be corrected—or at least avoided in the future. The Annual Enrollment Period happens every fall, but you may also qualify for Special Enrollment Periods during the year under certain conditions (like losing other coverage or moving).

Before the next enrollment season:

• Keep records of your current providers and prescriptions

• Revisit your healthcare usage patterns annually

• Pay close attention to any plan documents, especially the ANOC

Make sure you give yourself ample time to review changes and ask questions well before the December 7 deadline.

Protect Yourself from Common Errors in 2025

Medicare gives you valuable coverage options, but it requires annual attention and informed decision-making. Don’t treat Open Enrollment as a one-time task—treat it as an annual audit of your healthcare strategy.

You don’t have to do this alone. Speak with a licensed agent listed on this website to ensure your plan aligns with your needs for 2025 and beyond.